Using Simulation to Explore Empathy: Bridging Clinical Practice and Nursing Education

Kramer, Joan D.

Wednesday, July 13, 2011: 4:25 PM

Joan D. Kramer, PhD, MS, MBA, RN-BC
Nursing Program, Morgan State University, Baltimore, MD

Learning Objective 1: Develop a low fidelity nursing simulation activity that addresses the affective domain.

Learning Objective 2: Describe the steps in developing a simulation activity.

Simulations can be described as representations of reality, in which participants fulfill specific roles. Simulation has gained prominence as an interactive, learner-centered strategy in which students can experience a practice situation without fear of harming a patient, often while using programmable mannequins and equipment. Evidence shows that simulation activities result in a high degree of student satisfaction and perceived self-efficacy, improved interdisciplinary collaboration, and learning outcomes equal to or better than other teaching methods.

Most simulation activities involve clinical skills focused on the psychomotor domain. Simulations that focus on the affective domain are less prominent and are rarely mentioned in nursing texts addressing simulation. Eggenberger and Keller (2008) see simulation as a way to enhance student’s competency in caring. They describe how students can be helped to identify the “calls for nursing” in simulations, such as a patient’s “call” to be supported, or have his fear, courage, or trust understood in the moment. Benner, et al (2009) suggest that medical pathology and disease process should be taught in direct association with patients’ illness experiences, psychosocial aspects of illness, and coping abilities.

The simulation activity presented in this session explores empathy in caring for an ambulatory patient population. It has been used with over 300 nurses, providers, and medical/office assistants in these settings, and is currently being used with nursing students. The simulation participants are briefed and assigned an identity. They proceed through various stations experiencing a continuum of health and illness precipitated by randomly issued “life events” cards. The result is a type of unfolding case study for each individual. As participants accumulate both good and bad experiences with healthcare, they feel the economic, personal, and emotional consequences. In debriefing, we see that some have been more fortunate than others, but each one has a story to tell.

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